the Female Body GOVERNING

Notes
The Pill in Puerto Rico and the Mainland United States 181
1. Although U.S. feminists have often picked up the Nationalist argument that
there was a U.S. sponsored mass-sterilization campaign on the island, there
seems to be little evidence that this was the case. Clarence Gamble, on hearing
of the accusations that this was taking place, twice sent his own researchers
to the island to offer to help fund it. They could not fi nd any organized
campaign for sterilization, and were discouraged by government and public
health offi cials from starting one. See for example Christopher Tietze to
Clarence Gamble, Report 3, September 19, 1946; Report 8, September 25,
1946, Clarence J. Gamble Papers-Countway Library of Medicine, Box 46,
Folder 756 and Wilson Wing to Gamble, May 18, 1951, CJGP-CLM, B47, F774.
Nevertheless, it seems equally clear that there was also a considerable plurality
among physicians who thought sterilization was a good idea for working-class
people on the island, and undoubtedly there was improper pressure.
2. Puerto Rican “overpopulation” was everywhere in the news; in fact, it was
repeatedly cited as the root cause of all the economic problems of the island.
See “Puerto Rico: Problem Island,” New York Times Magazine, March 7, 1954,
pp. 10–11; Time, May 2 1949, cover article, p. 33; Time, April 23, 1958, cover
article, p. 30; “Growing Pains Beset Puerto Rico,” National Geographic Magazine,
April 1951, p. 24.
3. For examples of this narrative, see esp. the popular accounts, Maisel and
Vaughan. Pincus and Rock were also constructing a progesterone story;
the name of the 1954 project at Rock’s clinic was the Pincus Progesterone
Project (the PPP, or pee, pee, pee, as it came to be called, for the endless urine
collections).
4. This dates back to the earliest studies of “organotherapy” by Charles Edouard
Brown-Séquard in the late nineteenth century.
5. Anonymous reviewer for “Enovid, Ortho-Novum, and Thromboembolic
Effects,” Medical Letter. Rockefeller Archive Center, Rockefeller University,
Record Group 891, Martin Rizack papers, Box 45, Folder 1.13, March 1963.
6. Ramírez de Arrellano and Seipp, pp. 107–123, report the drop-out rate on
the Río Piedras series as 109 women out of 221 participants; 22% of these
dropped out because of side effects. For the Ryder series, 32.4% of participants
dropped out because of side effects, and 57% total had discontinued after two
years. Adaline Satterthwaite, “Experience,” p. 476.
7. C. Tietze to M. Snyder, August 15, 1957, CLM-CJGP, B48, F788. Gregory
Pincus et al., “Fertility Control with Oral Medication,” American Journal of
Obstetrics and Gynecology, 75 (Aprile 1958): 1333–1346. Oudshoorn criticizes
the use of the kind of “woman-years” statistic in the Pill trials in Puerto Rico.
However, this statistical device was not unique to these trials, but dated back
to the 1930s. Its strength was that it enabled researchers to compare divergent
experiences in length of use of a method and made it a simple matter to
deduct, for example, 10 months for a pregnancy or 3 months of a sexual
partners’ absence. Its shortcomings—in overstating researchers’ knowledge
of a method by making 12 women’s experience for one month comparable
to one woman’s experience for a year—were well-known to researchers, and
had spawned a literature of their own, establishing guidelines such as one
requiring that at least half of any cases reported in this way involve long-term
administration. (See Raymond Pearl in “Contraception and Fertility in 2,000
Women,” Human Biology, 4 (September 1932): 363–407.) Researchers were
aware that there was something wrong with the way it was used in the Pill
study. Wrote Christopher Tietze, “the aggregate number of person years of